Provider Demographics
NPI:1639226707
Name:PITTMAN, CATHERINE MARIE (PHD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:MARIE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 N MAIN ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1625
Mailing Address - Country:US
Mailing Address - Phone:574-234-3515
Mailing Address - Fax:574-234-3565
Practice Address - Street 1:108 N MAIN ST
Practice Address - Street 2:SUITE 305
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1625
Practice Address - Country:US
Practice Address - Phone:574-234-3515
Practice Address - Fax:574-234-3565
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041267A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical